New Grad off Orientation

[froggy93]

So I just wanted an outside opinion, I am a new grad who just finished orientation today. I am on a med surg unit in a large hospital ratio is 1:5. Every float that comes to our unit says how heavy our unit is and our patient load based on the types of patients we often get. I read all these things about how new grads struggle so much and feel overwhelmed for a really long time. I am scared to say it, but I honestly do not at all. There were some moments my first maybe 3 weeks where I definitely felt overwhelmed (I just finished 12 weeks of orientation), but overall I do not at all. I know I still have plenty of questions and things will always come up that I need to ask or clarify or get another opinion, but overall I feel confident. Don't get me wrong, there are days when I am running around completely crazy, but I never feel like I am going to panic or that it is impossible-I always feel like I know I can get it done. I have had 2 preceptors, both are really great. One who precepts almost all of the new grads on my unit specifically told me that she thinks I caught on really fast and that I must have had a good nursing school preceptorship (I was in the OR though-not on the floor), but I just want to know is there ANYONE that felt this way as a new grad? Aware that you are a new nurse, but feel pretty confident? All I read are things about how new grads struggle so much for awhile and I am just wondering if this is normal or if I am missing something.

[Zelda, RN]

I'm with you, OP. I started on a child psych floor. My orientation was shorter - I was taking a full load of pts (4-8) on my own after about 6 weeks. I always felt fairly confident in my abilities. Psych is a little different, as we have the ability to work more closely with our team members than on a typical medical floor. Our kids spend most of the evening in the day area together, and we only have one hall with rooms. Even so, there were some nights where I was the only nurse with two techs - no charge, nurses on the adult unit but that was the other side of the building. It was nerve wracking, but I never felt miserable, never went home crying. I still get nervous when a kid becomes agitated or starts acting out - my fight-or-flight kicks in and my flight instinct starts screaming at me to go, but I'm able to ignore it and calmly do what needs to be done (whether that's initiating a physical hold or talking to the kid until they calm down or giving an IM).

I'm getting ready to start on an acute med-surg peds floor though. So we'll see what happens to my confidence!

[kemansha1]

I am so glad that somebody else noticed how shrill this board can sometimes be. In my real life so far as a precept I have not had anyone be as mean as I have read on this board. Just because a person is confident in their abilities does not make them a cocky dangerous narcissist. Good on you OP for feeling like you made a good decision to be a nurse and then being good at your job. Don't let the haters bring you down.

[THELIVINGWORST, ASN, RN]

OP, I have felt the same way since I came off orientation. I am a quick learner and I have pretty good teaching and leadership qualities so I didn't really struggle much when I started two years ago. I have learned so much and I have enjoyed precepting and learning to work as a charge nurse as well.

I never cried and I never lost my cool at work. Some people are able to compartmentalize and stay cool when under pressure.

The way I see it, as long as you welcome feedback and teaching moments from senior nurses, you are right where you need to be.

[ESpeed15]

This could be a result of a great nursing school, great preceptors, and that you are meant to work I'm this department! I went to what I believe is an amazing nursing school. Almost every facility we went to had nothing but good things to say about students and registered nurses that have come from my school, even to the point of showing favor to us due to our overall work ethic. When I graduated, I knew that my instructors had prepared me to start working. I know that I don't know everything there is to know about nursing and probably never will, and I accept that, but I am confident about working. And there is nothing wrong with that!

I, too, have a 12 week orientation that will begin this week. I plan on asking as many questions and learning as much as I can from these nurses. I will be working with stroke patients and have already, on my own, gotten my certification for the NIHSS stroke scale. I don't see anything wrong with being confident about what you have learned and what you continue to learn, whether it is on the job or on your own time.

I would consider feeling confident after your orientation is due to the preceptor that you had. The fact that that one nurse precepts all the new nurses gives proof that she knows what she is doing and does it right!! I doubt that she would let someone go on the unit by themselves if they weren't ready.

There are some people that pick up skills and the routine and duties faster than others, and I think that makes a difference in how you feel when you come off orientation. That doesn't mean you are smarter or a better nurse, just that your better at hands on tasks.

Every preceptor program is different and each nurse has their own opinion to bring to the table when it comes to those experiences. Having a confident, organized, and knowledgeable preceptor will give the new nurse a different outlook than one that still gets everything done, but looks like a chicken running around with their head cut off every shift.

Yes, be confident, but also be humble. The more seasoned nurses have probably forgotten more about nursing than you will ever know! Take the good days and remember them, you will need them on the bad ones! Never stop learning from nurses, patients, and doctors! Everyone has something to teach and everyone has something to learn.